Anyone over 50 strongly advised to get a flu shot

Q: My husband is a diabetic with heart disease, but he has never followed his doctor's advice to get a flu shot. He had always been afraid of the side effects of the vaccine. Now he argues that he will not get the flu again this winter because he had an attack in January. Should I try harder to convince him to get a flu shot?

hTC A: Your husband should definitely follow the doctor's advice and get a flu shot soon. It takes one to two weeks for the vaccine to provide protection, and the flu season begins in November. Flu shots are strongly recommended for all people over the age of 50 and for those with chronic heart or lung disease, diabetes and a number of other disorders that are more likely to result in serious illness, even death, from a bout with the flu.

The vaccine is needed every year because flu viruses change so often that there is usually a new strain each year. So neither a previous shot nor a prior flu infection assures protection during the next flu season.

People who remember the paralytic illness (Guillain-Barre Syndrome) that followed injections of the swine flu vaccine in 1976 may still be afraid to get a flu shot. But most people have had no complications from the flu vaccines used in recent years. The only common side effect is soreness for a day or two at the site of the injection. Serious side effects are still possible, but their low frequency is much smaller than the danger of severe influenza in people at high risk. Nonetheless, some people need to check with their doctor before getting a flu shot. These include people who are allergic to eggs or had a severe reaction to a previous flu vaccine, women who might be pregnant and those who have a history of paralysis from Guillain-Barre syndrome. People who have a fever or other illness should delay getting the flu shot until they have recovered.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.